Cleveland Clinic journal of medicine
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Review
Central sensitization, chronic pain, and other symptoms: Better understanding, better management.
Central sensitization, a pathophysiologic process in which the central nervous system undergoes changes that alter its processing of pain and other sensory stimuli, may be the mechanism underlying various conditions in which patients have unexplained pain and fatigue. Patients frequently misunderstand the cause of their symptoms and pursue unnecessary evaluations and treatments. Clinicians have a pivotal role in decreasing this misunderstanding by providing patient education, which can affect perception, management, functional status, and quality of life.
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The 2022 guideline from the American College of Cardiology, American Heart Association, and Heart Failure Society of America provides practical recommendations for preventing, diagnosing, and managing patients with heart failure. This article summarizes the most important of these recommendations, specifically for managing patients with heart failure with reduced ejection fraction (HFrEF), and how they should change daily practice.
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Editorial Comment
Chronic centralized pain syndromes: A rheumatologist's perspective.
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Multiple sclerosis (MS) is commonly diagnosed in young adults during their reproductive years. Consequently, concerns about family planning and MS management related to pregnancy and breastfeeding are often encountered in clinical practice. ⋯ People with MS and their care team must engage in collaborative decision-making before, during, and after pregnancy. Based on the results of a consensus-building initiative, answers are provided to 20 frequently asked questions regarding the management of MS during pregnancy planning, pregnancy, and the postpartum period.